July 7, 2016

Dr. Janice Nigro, Filipodia Editor

 

I was pretty proud of myself for coming up with the terminology “your silent collaborator” in my first post in this series to describe what it is we do as editors. That is, until a couple weeks ago when I discovered a huge body of literature on the topic of disclosure in the field [1,2]. One question discussed in the literature that took me completely by surprise was, is medical writing and editing even ethical at all [3]?

 

The debate stems from the more controversial topic of ghostwriting in science [4]. Ghostwriting is the unethical practice of writing up science by one person while credit for the work goes to another. It is most often associated with the pharmaceutical industry penning articles but using the names of physicians or scientists to give legitimacy to a study. Ghostwriting however also occurs under other circumstances – when a senior person invites a junior person to write an article but takes the credit for having done so. Neither situation is ethical. In one there is a potential for bias and financial gain, and in the other it is unadulterated exploitation of a junior person.

 

Medical or science writing is something else entirely. A professional writer or editor assists a group of authors in the development of a manuscript where they alone can claim responsibility for the content. For many today, their only option is to seek professional help, especially if they want to publish in English.

 

Regardless of language capabilities, we all benefit tremendously from the naïve perspective of another science professional (maybe a colleague). They can fill in informational gaps that we often overlook and remove the excesses that detract from a story. As a result, our manuscripts have the chance to engage a broader spectrum of people. It’s an important consideration today especially, as science has become highly cross-disciplinary and is more widely available because of open access.

 

More of the responsibility of formatting manuscripts has been transferred to authors. It requires more attention to details and is more time consuming for authors. For some online journals, there may not even be a copy editor, so the submitted version of a manuscript and figures may go directly to a production team. Finally, more serious issues, such as plagiarism or duplication of material from a previous article, can be identified and dealt with by an editor before an article ever reaches a journal. In the end, professional intervention at the outset saves time for authors and journals alike.

 

Most of the literature is in agreement that we should not eliminate medical writers and editors [1,2]. It’s disclosure that we need. So how should we do that? In some cases, the contribution of an editor to the actual writing of a manuscript likely exceeds that of many co-authors. But should we really be considered as co-authors?1 I have been once, but it was for editing the work of a close colleague. The only clear scenario in which a writing professional might be included as a co-author is a review. In a review, authorship is more dependent on the contribution of ideas, not original data.

 

A more universal proposal is to formally acknowledge the professional help and the source of funding [1,2]. An alternative is to make a disclosure statement in the correspondence between editors, reviewers, and authors [2]. A practical reason for disclosure would be to alleviate bias against non-native English speaking authors. Where, for example, I might be allowed a few minor mistakes to be easily corrected by a copy editor, they often are not.

 

I have only worked anonymously in the business model I am in. We mainly edit articles and associated correspondence prepared by the authors themselves. It is some higher order type of editing because the work involves reorganization of the content as well as correcting the English. The important distinction is that we do not contribute content. One potential issue with applying transparency universally is that it transfers responsibility of the content onto the editors and writers. That is the purpose of disclosure – to discourage ghostwriting. However, do we want to confuse our positions as editors and writers with that of reviewer too? It’s tricky because we are doing a little of each of those jobs. Primarily as editors however, we “translate” so that authors and reviewers can do their job more easily.

 

For me, the question is no longer whether it’s ethical to hire medical or science writers and editors, but in what additional capacities can we impact the field. We see so much material before submission, it may be appropriate to ask “should we be more vocal about publishing strategies in our target countries,” for example.

 

We have to be careful not to exclude scientists from the worldwide discussion based on communication skills. And, if we are honest, we really all need help with writing. Speaking for myself and my editor and research colleagues, we do it as a courtesy for each other within our own networks – if we have time – but that’s because we can. For some, however, it’s not even an option.

 

Editing papers that come to me from the Internet is an unusual position to be in; my words make up sentences to tell someone else’s story. But the process is necessary and should be accepted as routine. To not provide assistance also seems unethical [5].

 

So what are your ideas on transparency in medical and science editing and writing?

 

 

 

Footnotes

1Guidelines for authorship are provided by individual journals, the International Committee of Medical Journal Editors (www.icmje.org), and Good Publication Practice (GPP3;[6]).

 

References

1. Woolley KL: Goodbye Ghostwriters!: How to work ethically and efficiently with professional medical writers. Chest 2006;130:921-923.
2. Das N, Das S: Hiring a professional medical writer: is it equivalent to ghostwriting? Biochem Med (Zagreb) 2014;24:19-24.
3. Bosch X, Ross JS: Ghostwriting: research misconduct, plagiarism, or fool’s gold? Am J Med 2012;125:324-326.
4. Gotzsche PC, Kassirer JP, Woolley KL, et al.: What should be done to tackle ghostwriting in the medical literature? PLoS Med 2009;6:e23.
5. Woolley K, Gertel A, Hamilton C, et al.: Don’t be a fool–don’t use fool’s gold. Am J Med 2012;125:e21-22; author reply e23.
6. Battisti WP, Wager E, Baltzer L, et al.: Good Publication Practice for Communicating Company-Sponsored Medical Research: GPP3. Ann Intern Med 2015;163:461-464.